Postoperative MRI for anorectal malformations

Abstract

Aim: To evaluate the role of MRI in detecting possible causes of incontinence in patients with anorectal malformations after the initial corrective surgery. Materials and methods: The study included 17 patients; age ranged from 1 to 18 years. T1 and T2 weighted images were obtained in axial, coronal and sagittal planes, sequences were obtained without fat saturation to easily identify low signal muscles against high signal fat. Results: MRI accurately assessed the grade of development of sphincter muscles; muscles graded as good in 4 patients, fair in 2 patients, poor in 5 patients and 3 cases had asymmetrical muscles. The position of pulled through bowel was laterally mislocated to the left side of the sphincter muscles in 2 cases and was anteriorly mislocated in 5 cases. Inadvertently placed mesenteric fat around the pulled through bowel was depicted in 10 out of 17 patients. Associated anomalies of the vertebral column, spinal cord and urogenital system was depicted in 11 patients. One case had classical caudal regression syndrome. Conclusion: MRI is very useful in the postoperative assessment in patients with anorectal malformations. It plays an important role in diagnosis of possible causes of incontinence, postoperative complications and detecting associated anomalies in one study. Keywords: Anorectal malformation, Pulled through bowel, Sphincter muscles, Sacral agensis, Magnetic resonance imaging, Fecal incontinence